Endoscopic Occuloplastic Surgery is the surgery of eye through transnasal approach. It includes endoscopic surgery for dacryocystitis, endoscopic eye surgery for tumors, endoscopic eye surgery for trauma, optic nerve decompression. Endonasal endoscopy is considered as minimally invasive approach to orbital lesions. Mainly the medial and inferior walls of orbit can be easily accessed through this approach. Endoscopic DCR surgery is routinely performed by ENT surgeons. It is done for chronic dacryocystitis where the obstruction is at the level of nasolacrimal duct. More commonly seen in elderly people. Optic nerve decompression is a procedure in which the optic nerve is decompressed in its intra canalicular segment. The overlying bone is removed and steroids are given along with it. It is considered as an emergency as patient shows maximum improvement in vision if the surgery is performed within first 6hours after trauma. Similarly evacuation of orbital haematoma following trauma can also be done through endoscopic approach. Most of these conditions require immediate surgery as prognosis is better when done as early as possible. Complications include bleeding, subcutaneous emphysema, orbital haematoma, damage to extraoccular muscles, CSF leak. Usually intra nasal pack is kept for 36-48hours. Patient requires indoor admission for 3-4 days.
Minimally invasive, cosmetic value, lesser morbidity, lesser complications and shorter duration of hospital stay
Approach to lateral and superior walls of orbit is difficult, more extensive diseases cannot be managed adequately by this approach
Steroids reduce the inflammatory edema and help to improve visual loss
Helps to control post operative bleeding
Most commonly Netcell/Merocell is kept. Sometimes nose is packed with roller gauze
Pre operative and post operative evaluation of patient is done by opthalmologists. Opthalmologists are integral part of operating team.
